Codeine

Codeine is used to relieve mild to moderate pain. It is also used, usually in combination with other medications, to reduce coughing. Combination products that contain codeine and promethazine should not be used in children younger than 16 years of age. Codeine will help relieve symptoms but will not treat the cause of symptoms or speed recovery. Codeine belongs to a class of medications called opiate (narcotic) analgesics and to a class of medications called antitussives. When codeine is used to treat pain, it works by changing the way the body senses pain. When codeine is used to reduce coughing, it works by decreasing the activity in the part of the brain that causes coughing.

Codeine is also available in combination with acetaminophen (Capital and Codeine, Tylenol with Codeine); aspirin; and in many cough and cold medications. This monograph only includes information about the use of codeine. If you are taking a codeine combination product, be sure to read information about all the ingredients in the product you are taking and ask your doctor or pharmacist for more information.

Codeine (alone or in combination with other medications) comes as a tablet, a capsule, and a solution (liquid) to take by mouth. It is usually taken every 4 to 6 hours as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take codeine exactly as directed.

Codeine can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.

Shake the solution well before each use to mix the medication evenly. Do not use a household spoon to measure your dose. Use the measuring cup or spoon that came with the medication or use a spoon that is made especially for measuring medication.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking codeine,

• tell your doctor and pharmacist if you are allergic to codeine, any other medications, or any of the ingredients in the codeine product you plan to take. Ask your doctor or pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants; medications for cough, cold, or allergies; medications for anxiety, mental illness, nausea, or seizures; monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); sedatives; sleeping pills; and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have had recent abdominal or urinary tract surgery. Also tell your doctor if you have or have ever had a head injury; a brain tumor; any condition causing increased pressure in your brain; seizures; mental illness; lung disease such as asthma, chronic obstructive pulmonary disease (COPD, a group of diseases that cause gradual loss of lung function), or other breathing problems; prostatic hypertrophy (enlargement of a male reproductive gland); urinary problems; low blood pressure; Addison's disease (condition in which the body does not make enough of certain natural substances); allergies; or thyroid, pancreatic, intestinal, gallbladder, liver, or kidney disease.
• tell your doctor if you are pregnant or plan to become pregnant. If you become pregnant while taking codeine, call your doctor.
• tell your doctor if you are breast-feeding. Some women who take codeine may have increased amounts of the medication in their breast milk, which can cause serious or life-threatening side effects in their breast-fed babies. Call your doctor immediately if you become very sleepy and have difficulty caring for your baby. You should also call your baby's doctor or get emergency help if your baby is sleepier than usual, has trouble breast-feeding or breathing, or becomes limp.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking codeine.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. If you are giving codeine to a child, watch the child to be sure he or she does not get hurt while riding a bike or participating in other activities that could be dangerous.
• talk to your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects of codeine worse.
• you should know that codeine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking codeine. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
• you should know that codeine may cause constipation. Talk to your doctor about changing your diet and using other medications to treat or prevent constipation.

Unless your doctor tells you otherwise, continue your normal diet.

Codeine is usually taken as needed. If your doctor has told you to take codeine regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Codeine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• dizziness

• lightheadedness

• headache

• drowsiness

• mood changes

• nausea

• vomiting

• constipation

• stomach pain

• difficulty urinating

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• difficulty breathing or swallowing

• fast, pounding, or irregular heartbeat

• rash

• itching

• hives

• changes in vision

• seizures

Codeine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/Safety/MedWatch] or by phone [1-800-332-1088].

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• difficulty breathing

• excessive drowsiness

• loss of consciousness

• loss of muscle tone

• cold and clammy skin

• fainting

• dizziness

• slow heartbeat

Keep all appointments with your doctor.

Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking codeine.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Last Revised - 10/15/2011